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Original Research Communication |
1 From the Department of Nutrition and Health, the Research Institute of Child Nutrition, Dortmund, Germany.
Background: There is increasing evidence that acid-base status has a significant effect on high-intensity physical performance, urolithiasis, and calcium metabolism. Experimental studies in adults showed that renal net acid excretion (NAE) can be reliably estimated from the composition of diets.
Objective: We investigated whether a reasonable estimation of NAE is also possible from the dietary records of free-living children and adolescents.
Design: Healthy children (aged 8 y; n = 165) and adolescents (aged 16–18 y; n = 73) each collected a 24-h urine sample and completed a weighed diet record on the same day. Urinary NAE was analyzed (NAEan) and estimated (NAEes). Potential renal acid load (PRAL), the diet-based component of NAEes, corrects for intestinal absorption of ingested minerals and sulfur-containing protein. A urinary excretion rate of organic acids (OAs) proportional to body surface area was assumed for the complete estimate (NAEes = PRAL + OAes).
Results: Significant (P < 0.001) correlations between NAEes and NAEan were seen in the children (r = 0.43) and the adolescents (r = 0.51). A simplified estimate based on only 4 components of dietary PRAL (protein, phosphorus, potassium, and magnesium) yielded almost identical associations. Mean simplified NAEes (32.6 ± 13.9 and 58.4 ± 22.0 mEq/d in the children and the adolescents, respectively) agreed reasonably with NAEan (32.4 ± 15.5 and 52.8 ± 24.3 mEq/d, respectively).
Conclusions: Predicting NAE from dietary intakes, food tables, and anthropometric data is also applicable during growth and yields appropriate estimates even when self-selected diets are consumed. The PRAL estimate based on only 4 nutrients may allow relatively simple assessment of the acidity of foods and diets.Am J Clin Nutr 2003;77:–60.
Key Words: Biomarkers • children • adolescents • dietary record • food table • mineral intake • nutrient bioavailability • potential renal acid load • protein intake • renal net acid excretion • 24-h urine collection
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